A Retrospective Analysis Of Neonatal Pneumonia Cases In Certain Hospital In Changchun City

Neonatal pneumonia(NP) is the most common and the most severe respiratory disease in the neonatal period. As the neonatal respiratory function ofthe newborn is not yet mature, in case ofneonatal pneumonia, if it is not treated in a timely manner, closely observed to detect and deal with problems as soon as possible, the disease is very likely to cause respiratory failure, heart failure and other serious complications and even result indeath. It may increase the burden of hospital expenses as well. So it is necessary to conduct in-depth studies and explorations ofthe factors upon neonatal pneumonia, its adverse prognosis and hospital expenses.Objective: The retrospective analysis of cases of neonatal pneumoniawill help us understand the basic situations and clinical features of neonatal pneumonia, and explore the adverse factors on bad prognosis of neonatal pneumonia and hospitalization cost, so as to provide reference basis forreducing the incidence of neonatal pneumoniaand its poor prognosis and hospital costs.Methods: It is the case-review method. We selected 510 cases of neonatal pneumonia in certain hospital of Changchun from January 2014 to December 2015, collecting the basic information of the newborns, their clinical characteristics, the auxiliary examinations,the treatment measures, the prognosis, the hospital costs, etc. The chi-square test was used for the adoption rate of the counting materials, the descriptions of the composition ratio and the comparison rate of different groups. Among the metrological data, the median and the quartile ranges were described; the median comparison among different groups was carried out by means of the rank sum test; the risk factors that may cause poor prognosis of neonatal pneumonia was analyzed with the binary logistic regression analysis; and multivariate linear stepwise regression analysis was used to analyze the influence factors on the hospitalization expenses of the children suffering from neonatal pneumonia. The Epi Data3.1 was used to establish the database and data entry, and the SPSS20.0 statistical software was used for the statistical analyses.Results: This retrospective study collected 510 cases of neonatal pneumonia, most of which were late newborns that accounted for 60.4%, while males were slightly more than females, accounting for 58.2%. Most of the cases were newborns of the cesarean section, numbering 311 cases, accounting for 61.0%. The disease happens mostly in winter and spring, and there were 173 cases and 157 cases respectively, accounting for 33.9% and 30.8% respectively. Of the complications, the most common was myocardial damage, and there were 159 such cases, accounting for 31.2%.Among the children patients, the incidence of poor prognosis was 3.33%. The univariate chi-square test showed that the incidence of poor prognosis was higher among the children with fever than those without fever; the incidence of poor prognosis was higher among the children with neonatal resuscitation than those without neonatal resuscitation; the incidence of adverse prognosis increased with the increase of spiritual sag among the children; the incidence of bad prognosis increased with the increase of the number of complications. All the differences were statistically significant(P <0.05). However, the differences were not statistically significant(P> 0.05) in terms of the newborns blood analysis, CRP, myocardial enzyme status and chest radiograph when they suffered from neonatal pneumonia. The multivariate binary logistic analysis revealed that the number of complications was ? 2(OR = 16.586, P <0.05), which constituted some risk factors for neonatal pneumonia.The median hospitalization costs of neonatal pneumonia was 7171.03 yuan. The single-factor rank sum test showed that the hospitalization cost was higher for the early neonatal group than the late neonatal group, and the inpatient expense was higher for the premature delivery group than the non-preterm labor group. Regarding the infant hospitalization seasons, the hospitalization cost was higher in winter and spring than that in summer and autumn. Among the infants with neonatal pneumonia, the hospitalization cost was higher for those with abnormal respiratory rate than those with normal respiratory rate. The hospitalization cost was higher for the neonatal pneumonia infants with the inspiratory three depression sign than those without the inspiratory three depression sign. Among the neonatal pneumonia patients, more complications would lead to more hospitalization costs, and longer hospitalization periods would lead to more hospitalization costs. The differences were statistically significant(P <0.05).The differences of neonatal pneumonia in hospitalization costs were not statistically significant in terms of sex, birth weight and payment methods(P> 0.05). The multiple linear and stepwise analysis showed that the days of hospitalization(?'= 0.807, 95% CI: 0.121 ~ 0.137), the number of complications was 1(?'= 0.091, 95% CI: 0.054 ~ 0.189), the number of complications of?2(??= 0.048,95%CI:-0.004~0.297), the hospitalization days(??=-0.088,95%CI:-0.009~0.003), and the inspiratory three depression sign(?' = 0.078, 95% CI :-0.054 ~ 0.232) were the influence factors of hospitalization cost.Conclusions: 1. Among theneonatal pneumonia cases in the hospital in Changchun, most of the patients were of caesarean birthand born in winter and spring.2. Among theneonatal pneumonia cases in the hospital in Changchun, the majority of the complications was myocardial damage. In clinical practice, we should pay more attention to themyocardial damage in the neonatal pneumonia patients.3. At hospitalization admission, the risk factors on prognosis of neonatal pneumonia included fever, poor mental reaction, the need for neonatal resuscitation, and a large number of complications, and the number of complications of neonatal pneumonia was an independent prognostic factor. In clinical practice, thetreatment, control and prevention of these factorsshould be emphasized and intensified.4. The independent influence factors of hospitalization costs of infants with neonatal pneumonia were hospitalization days, complication number, age and the inspiratory three depression sign. Reducing unnecessary hospitalization days and timely control of the disease areimportant means of controlling hospital costs.